Dr Robert Montgomery led transplant programmes while facing a heart condition

Dr Robert Montgomery faced his own mortality while leading organ transplant programmes, dealing with a rare genetic heart condition that threatened his life and career.

Living With Dilated Cardiomyopathy

Montgomery first wanted to be a veterinarian before his father developed dilated cardiomyopathy when Montgomery was 14 years old. The rare disease causes the heart chambers to stretch and enlarge, leading to heart failure, irregular heart beats, cardiac arrest, and sudden death. His father died in 1976.

Eleven years later, Montgomery started a surgical residency at Johns Hopkins Medicine when his 35-year-old brother, Rich, died that morning from the same condition. Pathologists discovered the disease was likely caused by a genetic mutation, and subsequent evaluations confirmed that Montgomery also carried the condition.

Surviving Cardiac Arrest in Patagonia

The first time Montgomery went into cardiac arrest and died briefly, he was hiking in Patagonia near the southernmost tip of South America in 2010. He felt his racing heart as he lagged behind his son John and their guide, then collapsed face down into the snow. A medical device implanted in his chest delivered a shock seconds later that restored his heartbeat and saved his life.

When medication failed to keep his arrhythmia in check, Montgomery had opted for an implantable cardioverter-defibrillator, or ICD. Despite the near-death experience, he returned to the same spot in Patagonia in 2017 to spend time with his sons John and Max, where he went into cardiac arrest again.

Reforming Organ Transplantation at Johns Hopkins and NYU Langone

Unsure if he could complete his surgical residency, Montgomery studied immunology in England and pursued a doctorate just in case surgery was no longer an option. He returned to Johns Hopkins in 1992 and focused on kidney transplants, helping develop a minimally invasive surgical technique for retrieving kidneys from healthy living donors.

In 2001, Montgomery started a programme to swap kidneys between incompatible, donor-recipient pairs to increase transplant numbers. He and his team soon performed domino donations, where an altruistic donor gave a kidney to a stranger so another nonmatching donor could give to a second recipient. Brigitte Sullivan, a transplant administrator, described him as a bit of a cowboy, and Montgomery described her as a fellow visionary. In 2016, NYU Langone Health recruited Montgomery to build an organ transplant programme in Manhattan.

Waiting for a Donor Heart

Montgomery’s personal experience of waiting for a heart transplant laid bare the challenges of the medical system he attempted to fix. In Ireland, approximately 660 people currently wait for an organ transplant, with about 100 on the list for other organs including six patients waiting specifically for a heart transplant.